Degenerative Osteoarthritis – Cervical Spine
MEDICAL HISTORY:
The patient is a 39-year-old yoga instructor who has a one year history of severe pain in the cervical spine, progressive in nature. There is no history of specific injuries recorded; however, her work may have gradually resulted in producing the problem. There is radiation of pain to both upper extremities which were also subject to “heavy” sensations, pain, numbness and tingling, particularly on the left side. These were accompanied by a significant restriction of the range of motion of the cervical spine and severe headaches extending from the occiput to the frontal areas. She previously underwent a course of extensive magnetic therapy in Switzerland and has had acupuncture and massage therapy for prolonged periods of time. She required up to 10 Ibuprofen tabs. per day. She has seen a neurologist and a neurosurgeon who advised surgical intervention.
PHYSICAL EXAMINATION:
The patient is right handed. The right grip is 35 and the left 30 lbs. There is a normal range of motion of both shoulders and the thoracolumbar spine. The range of motion of the cervical spine with regard to flexion, extension, lateral rotation and lateral flexion is less than 60% of normal. Acute tenderness is noted from C3-6. A moderate degree of paracervical muscle spasm is present. Neurological examination is within normal limits.
RADIOLOGICAL STUDIES:
The MRI demonstrates foraminal stenosis at C5-6 and C6-7. This is accompanied by degenerative disc disease and central stenosis C5-6 and C6-7.
DIAGNOSIS:
Degenerative Osteoarthritis – Cervical Spine
DISCUSSION:
This patient had 12 Laser Therapy treatments between May 5, 2010 and June 23, 2010. On the occasion of her most recent visit, June 23rd, she reported only occasional mild headaches and barely perceptible numbness and tingling in the fingertips, only when elevating the extremities to the maximum degree. She has not used medication over the past 2 weeks, although she had not yet resumed her activities as a yoga instructor. The right grip strength had improved from the original 35 to 50 lbs. and the left from 30 to 60 lbs.
RECOMMENDATION FOR FUTURE THERAPY:
With regard to subjective findings, the patient feels that her status is now relatively normal. She does not require any medication.
In order to maintain the degree of improvement established, we have recommended treatments 2 times per week for 3 weeks and then treatments weekly on a subsequent basis for an additional 4 weeks. The patient will then be discharged and further treatment will be based on recurrence. The majority of these cases are followed carefully and 70% do not require additional treatment in the future. Occasionally we recommend treatments 1-2 times per month to prevent recurrence.
CONCLUSION:
This case once again demonstrates the effectiveness of Laser Therapy in resolving problematic medical conditions and has been instrumental in avoiding the laminectomy and spinal fusion recommended.